Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston.
Department of Dermatology, The Marshfield Clinic, Marshfield, Wisconsin.
J Am Acad Dermatol. 2016 Jan;74(1):1-16; quiz 17-8. doi: 10.1016/j.jaad.2015.06.033.
Misdiagnosis may result from biopsy site selection, technique, or choice of transport media. Important potential sources of error include false-negative direct immunofluorescence results based on poor site selection, uninformative biopsy specimens based on both site selection and technique, and spurious interpretations of pigmented lesions and nonmelanoma skin cancer based on biopsy technique. Part I of this 2-part continuing medical education article addresses common pitfalls involving site selection and biopsy technique in the diagnosis of bullous diseases, vasculitis, panniculitis, connective tissue diseases, drug eruptions, graft-versus-host disease, staphylococcal scalded skin syndrome, hair disorders, and neoplastic disorders. Understanding these potential pitfalls can result in improved diagnostic yield and patient outcomes.
误诊可能源于活检部位选择、技术或运输介质的选择。重要的潜在误差源包括基于不佳部位选择的直接免疫荧光结果假阴性、基于部位选择和技术的无信息活检标本,以及基于活检技术的色素沉着病变和非黑素瘤皮肤癌的虚假解释。这篇由两部分组成的继续教育文章的第一部分涉及在大疱性疾病、血管炎、脂膜炎、结缔组织疾病、药物反应、移植物抗宿主病、葡萄球菌性烫伤样皮肤综合征、毛发疾病和肿瘤性疾病的诊断中,常见的涉及活检部位选择和技术的陷阱。了解这些潜在的陷阱可以提高诊断的效果并改善患者的预后。